Exclusive interview with ISEF alumnus Dr. Yitschak Biton from Hadassah University Hospital Ein Kerem in Jerusalem.

It is my pleasure to introduce Dr. Yitschak Biton. Dr. Biton was an ISEF Scholar for over a decade. He received his post-doctoral training at Harvard University as an ISEF International Fellow. At present, he is a leading cardiologist specializing in interventional electrophysiology at Hadassah University Hospital Ein Kerem, in Jerusalem. Dr. Biton has won several major awards and exemplifies everything ISEF embraces and encourages. Today he will be sharing his observation, professional experience and updates about the evolving COVID-19 outbreak in Israel.

Shalom Dr. Biton and thank you very much for joining me today. I know your time is precious so let’s dive right in…

Can you speak a bit about the research that is taking place to learn more about the virus? In a broad sense, what is the most important thing you (and your colleagues) have learned so far, and more specifically what are the cardiac implications of the virus?

Dr. Yitschak Biton: Well, that’s a great question. Obviously, there’s a lot of research going on. This is not the main thing that we focus on in cardiology. Because this is a virus, it’s more of a subspecialty of the infectious disease center and pulmonologists, but we do help because there are cardiac complications, as you implied.  Basically, the research involves medication, it’s about the symptoms and about a way to treat the virus. Currently, we cardiologists are only giving supportive care because we are actually seeing the virus.

The research in Israel is actually groundbreaking research. We have the Biological Institute in Ness Tziona, and they are working on a vaccine. I believe that they are very close to actually finding one. Hopefully, in the next couple of months maybe, we will have the vaccine.

In terms of cardiology, so there are some complications–cardiological complications. The main issue is that some of these patients have myocarditis, which is an inflammation of the heart. And some other important things to check are the medications that are now being used. This is the Hydroxychloroquine, which is anti-malaria medication, and some other medications. All these medications can cause arrhythmia–problems with the heart rhythm–and we cardiologists do help with that. Actually, the research that I did with ISEF, under the sponsorship of ISEF, was about QT prolongation (which means the heart muscle takes longer than normal to recharge between beats), So this is the issue with those medications. Specifically, they prolong the QT interval ECG, so they can cause arrhythmia. So, we know the mechanism as you say, it actually helps us to try to predict who are the patients that will experience arrhythmia. This is perhaps a small thing, but an important thing that helps us to treat those patients.

You mentioned ISEF – have you found yourself using any of the academic tools, leadership skills and even social values you acquired as a student and member of the ISEF community?

Dr. Biton: Yes, I am actually very lucky to be a graduate of ISEF programs, and I use what I learned every day, not just dealing with the COVID situation. Obviously more so now, because we are dealing with a disease that has no treatment; as such, the skills that we need are actually more the social skills, because we need to talk with the patients. You know, they are in an uncertain situation and some of them are actually at high risk of dying. And we need to explain the situation in a way that will be easy for them to comprehend. So obviously it’s not an easy situation, and it’s a difficult situation for us too. These are patients that, you know, are not even allowed to talk with their family. It is in fact an unusual situation. When you are with a patient that you may need to intubate, meaning to insert a tube and place on a ventilator to support his breathing, and he cannot talk with his family. So, we are dealing with a unique situation where we need to communicate with the families through video conferences. We have never had this before. So yes, you know there are skills that I learned at ISEF that I definitely use. It’s mainly social skills.

And finally, what has been your personal experience with the outbreak – how has it affected your daily life? Your family?

Dr. Biton: It is an issue because, as you know, we the medical staff are in the front lines at a tertiary hospital, the major hospital in the Jerusalem area. We are serving about 2 million people – so just imagine. And you know, when I come back home, in a way I’m risking, I’m endangering my family because there is no way that I will not treat a patient with Corona, a patient with COVID.  We have some situations in which we have to perform some procedures, obviously life-saving procedures, on these patients. And you know, we do that, and we’re happy to do that, we’re happy to help. But in the back of my mind, there is always the thought when coming back home, that I don’t know if I’m going to catch the virus or not. And you know, I have two little kids and my wife. Obviously, I’m not meeting my own parents – they are 70 years old. This is the high-risk population. So yes, this is difficult.

Would you like to share any wisdom/advice with the ISEF Community before we end the call?

Dr. Biton: Yes, actually I want to share some wisdom. You know, when this COVID situation started, the government didn’t take action. We used the Internet, we used social media to actually reach out to our patients, even before we had the lockdown. I asked my friends in the broader sense not to leave home and to be in a voluntary lockdown, because you know, no one is immune. Even if you think that you have a lot of education, and maybe you have money, no one is immune. So, I want to tell everybody, please, you know you don’t need to wait for your government. I am talking to my colleagues in the U.S. I am talking to colleagues in Italy and Russia and I have some colleagues in Spain. I am asking you, the people, to take your own action. Don’t wait for the government to put you on lockdown. Stay at home. You know this is a virus, it’s not going to spread if you are going to stay home in quarantine. If you do that you are going to save your life, you are going to save your parent’s life, and your grandfather and your grandmother. We don’t know much yet. We will have the vaccine. We are going to win this war, we are going to eradicate this virus, but we want to do it with minimum casualties. I don’t want to see people dying. It’s so easy – just stay home.

Thank you, Dr. Biton, for this very informative discussion and for sparing time out of your busy schedule to tell us about the good work you are doing.

Thank you so much!
And to our ISEF community, thanks so much for listening- I hope you found this conversation as informative as I did.